A Case of Reperforated Duodenal Ulcer Successfully Ttreated by Laparoscopic Omental Implantation Repair

Shoki Mikata, Kazuhiro Iwase, Jun Higaki, Yasushi Tanaka, Masato Yoshikawa, Tomono Kishimoto and Wataru Kamiike

Departments of Surgery, Rinku General Medical Center, Izumisano Municipal Hospital

A 49-year-old man undergoing a laparoscopic omental implantation for a perforated duodenal ulcer was prescribed a full dose of H₂ receptor antagonist in October 1997. Six months after surgery, he was underwent endoscopy again, was found to have no duodenal ulcer, and H₂ receptor antagonist medication was stopped. He was admitted for severe epigastric pain and suspected of a reperforated duodenal ulcer after abdominal radiography on June 15, 1998, necessitating emergency surgery. The perforation was found in the anterior wall of the first portion of the duodenum, as previously. A short time after symptoms developed, he underwent laparoscopic omental implantation repair again. In endoscopy 4 months later, although no ulcer was found, H₂ receptor antagonist therapy was continued. No further ulcers have recurred in the 3 years and 11 months since the last surgery. Laparoscopic omental implantation for reperforated duodenal ulcer should therefore be taken into consideration in such cases.

Key words
reperforated duodenal ulcer, laparoscopic omental implantation repair

Reprint requests
Shoki Mikata Rinku General Medical Cener, Izumisano Municipal Hospital 2-23, Rinku-Orai-Kita, Izumisano, 598-8577 JAPAN

Accepted
October 30, 2002

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